Do Arthritis Treatments Like Synflex Work?
Osteoarthritis and the little big business: Some arthritis facts on Synflex
Today, I’m happy to bring you a guest post by Lothar M. Kirsch, M.D. Dr. Kirsch practices rheumatology in Germany. In addition to treating Rheumatoid Arthritis, his pursuits include nutrition, travelling, Zen meditation, and dispelling medical myths. He speaks several languages, including Chinese.
In today’s blog, Dr. Kirsch examines the claims of the so-called arthritis treatment Synflex. I hope you’ll enjoy the way he confronts arthritis cure claims as much as I enjoy it. It’s great to see that RA doctors can be funny, too.
A doctor asks whether Synflex can treat arthritis symptoms
Is Osteoarthritis (OA) a topic for patients suffering from Rheumatoid Arthritis (RA)? Of course, as we age, most of us have arthritis symptoms (OA). Some people get it more easily than others, but Rheumatoid Arthritis patients have even more Osteoarthritis in addition to their Rheumatoid Arthritis symptoms. This is often referred to as “Post Arthritic OA.”
What are the causes of arthritis (OA)?
What happens is the chaotic breakdown of processes that once were meant to maintain the health of the cartilage. As the outer appearance of the joint changes and movement is hampered, less nutrients and oxygen reach the cartilage and more waste is accumulated. This even increases the speed of changes in the joint. And this is the point where industry steps in. There are lots of manufacturers for glucosamine, but recently I came across Synflex.
Are arthritis treatments worth the money?
Someone wants to make money selling a product. Nothing wrong with this! But you have to pay for it. The claim of their arthritis treatment: “Not only does it help alleviate pain, it can also aid in greater flexibility and in the repair of damaged cartilege.” The words help and aid aren’t defined here – so the manufacturer is only giving some catch words, some magical words, but keeping any evidence out of sight.
Looking closer at amazing arthritis treatment claims
“Liquid glucosamine is an effective alternative to expensive injections to relieve joint pains. Synflex, thus, offers faster absorption …” There is no study which can prove the claim of “effective alternative” (whatever that means!) Faster absorption than an injection? That isn’t possible.
And how much glucosamine actually reaches the joint? I pondered very long about the following words: “One tried and tested way of supplementing joint cartilege thinning …” I finally concluded that it’s better to not speculate on what might have been the idea behind these obscure words.
“Synflex doesn’t just contain glucosamine. It also has many other powerful ingredients that can benefit you. These include: Vitamin C, E, and A. Synflex also has Omega-3 fatty acids. Synflex also contains Shark Cartilage which has 20 percent Chondroitin Sulfate. You will also find Yucca Powder, Boswellin, and Bromelain in the formula.” Vitamin supplementation doesn’t change OA arthritis symptoms [ACR 2009 Philadelphia]. However, it is true that eating foods rich in Vitamin C, E, and beta-carotenes may help avoid it [Framingham Study].
“Synflex also has no serious side effects, unlike Vioxx, Celebrex or Cox-II inhibitors.” Vioxx was taken off the market not because of actual side effects, but because of legal concerns of the manufacturer, who had been paid, used up nearly all time of product protection, and didn’t want to be sued for alleged side effects.
What might persuade someone to use a product like Synflex for arthritis symptoms – or any other glucosamine product? It isn’t science; it’s the magic of words like: “Synflex,” “help,” “aid,” “joint pain relief,” “no serious side effects”. I don’t think that glucosamine will harm your body; I think it will harm your purse.
Dr. Kirsch has been a member of the RA Warrior blog from its early days on Blogger. His investigative mind and humorous spirit have been encouraging me. I hope you’ll check out his RA blog from time to time, although much of it is in German! Thank you, doctor!
Recommended reading:
- How well do Biologic medications help Rheumatoid Arthritis?
- Do You Take Methotrexate for Rheumatoid Arthritis?
- Medical Records Tip for Rheumatoid Arthritis: Read the Doctors’ notes
- Rheumatoid Arthritis Requires Disease Treatment and Symptom Treatment
Oh what a breath of fresh air. Now if I can just get my family and friends to quit trying to shove the latest so called micacle cure down my throat. I don’t have any issues with a good vitamin support, but I would rather call a spade a spade. It’s just vitamins. If there was anykind of REAL CURE out there, it would be shouted by the medical community from the top of their lungs. So until I hear the DR’s stand up and announce they have found the cure, I’ll save my money for the meds I need to cope with this disease.
Yes, Julie, you’re right. We are a long way from a cure, scientifically speaking & when we get close, we will hear about it as you say!! :shout:
Meanwhile, may I add: We need to use medicines which actually fight this disease. Treating symptoms helps people feel better, but there are more important things, like extending our lives! :-/
Dr. Kirsch,
Thank you for being a part of our community. The doctors and nurses who read this blog hold a special place in my heart because we can make progress when we are all participating and sharing ideas.
Thank you for confronting “arthritis cure claims” head on. I think those companies can say anything they want, confusing patients and as Julie said, confusing our caregivers who think we are just being dramatic by taking chemotherapy when a vitamin would work as well.
I agree here. I’ve had so many people recommend treatments other than the MTX and various DMARDs, as those made me sick. My cousin is a respected Naturopath/Homeopath, and made a lot of suggestions that made sense–similar to Synflex (only through his own company), and wanted me to go on a cleansing diet and see if the arthritis was food- or allergy-related. None of these actually helped. I have RA and Osteoarthritis, so it’s a tough road, but taking the drugs meant for the diseases are the path for most of us to stop the progression. However, feeling lousy on the drugs is another story altogether… Thanks for posting this Kelly and Dr. Kirsch.
Thanks Hilary.
Do some people think we are so dumb that we haven’t looked into allergies & vitamins. If vitamins could cure or even treat Rheumatoid Arthritis, do they think it could be kept such a big secret? For Pete’s sake!
You (& I) are not dumb at all, but smart & brave enough to fight RA with the best methods available today. :yes:
Dr. Kirsch, this was an excellent parsing of the language that is used on nutritional supplements to skirt the FDA’s ban on making claims of safety or efficacy (because if those are made, the FDA can then regulate the product as a drug and require a full clinical analysis).
The approval for sales of an Over-The-Counter nutritional supplement is often assumed by naive consumers to be an FDA endorsement of efficacy. This is not true. Since Linus Pauling lobbied for Vitamin C in the 1980s, the FDA has no power to assess the efficacy of nutritional products that do not make overt claims of efficacy.
I think that US patients need to understand that nutritional supplements and “nutraceuticals” are not subject to the same regulatory scrutiny as prescription drugs as long as they use these weasel words.
In addition, I think it might be helpful to note that several large trials have been conducted on glucosamine. One of the most public here in the US was the one conducted by the National Institute of Health’s Center for Complimentary and Alternative Medicine.
This study showed that glucosamine has no benefit on joint destruction:
In the ancillary study, interested GAIT patients were offered the opportunity to continue their original study treatment for an additional 18 months, for a total of 2 years. At the end of the ancillary study, the team had gathered data on 581 knees. After assessing the x-ray data, the researchers concluded that glucosamine and chondroitin sulfate, together or alone, appeared to fare no better than placebo in slowing loss of cartilage in osteoarthritis of the knee.
A subset of patients (those with more severe pain) received some symptomatic relief from glucosamine in the study, whereas all segments of patients benefited from the active control, Celebrex. Such weak findings of efficacy may be a real effect, or may be a statistical fluke, and the NIH stated that a further, larger study would be required to confirm them.
This review looks at the evidence-based literature and highlights the inconsistent performance of glucosamine on pain relief. I think it is clear from the literature that the most one can say about glucosamine is that it may have a minor symptomatic benefit, and in no way preserves cartilage from destruction in OA.
Thanks, John for the additional data, good to have these studies published. Some studies on chondroitin or glucosamine are regularly presented at the ACR or EULAR congresses. Afterwards the abstracts or studies are quoted, but not the criticism by the audience, when for instance such a study is heavily criticized because of statistical tricks (p value set at 0,10 for instance).
Lothar (Rheumatologe on Twitter)
PS. I didn’t have access for a couple of days.
Kelly, everytime I log on here, I feel better mentally because I feel more informed with each log on, you have no idea how apprecicated your blog is… thanks
Viesta, You are so sweet, someone’s going to think you are my mom or one of my kids undercover… 😎
Haha. Thanks. This is a touchy topic, but companies like this do not have to prove their statements are true or that their product is effective before selling to us. It’s up to us to figure it out. :-/
Help me out here.
I’ve got a question about the statistics used in scientific studies, and how it pertains to us as individuals within a mass of people who presumably fit the usual bell curve.
“A subset of patients (those with more severe pain) received some symptomatic relief from glucosamine in the study”
When it gets to a scientific medical study, there is a presumption that the substance being tested is being tested because someone has a reasonable reason for doing so, like wanting to see if anecdotal claims bear more rigorous scrutiny. They don’t do a study on whether grape Koolaid is a miracle cure for RA unless there has been sufficient anecdotal or lab evidence to show it would be worth putting it to a test.
As individual consumers, we’ve all been in those situations where a drug or substance or practice (and I’ll just say “medicine” to stand for all those things) worked well for us, where it didn’t for most people, or vice versa. That may be regardless of whether the end results showed a bell curve with the mass of people getting the same range of responses, or maybe a 49-51 difference where there is little difference beyond the margin of error (I have no scientific training).
In this case, as long as we can be sure that the demographics were vetted sufficiently closely to make sure that the glucosamine WAS probably the variable that mattered for those with more severe pain, the study seems to thus say that for some people it was valuable.
Without replicating the studies or having access to sufficient data ourselves, how do we make the choices to take results of scientific studies with a pinch of salt or not? And that’s also with understanding that the placebo effect is maybe okay if the results it gets are the ones we need (bodies and minds are such funny things…).
(That’s assuming that we can also filter out the weasel words used by those who are going to make a profit off us at the consumer level).
It’s hard work to find out, what is wrong, when studies are tampered. Sometime signs are obvious, as for instance a p-value of 0.10 instead of 0.05, or the use of inappropriate statistical tests. Sometimes there is this small subset, and suddenly all talk is only about these “responders”. Glucosamine is more than 40 years on the market. In some countries it’s sold as nutriceutical and in some countries as a drug. A real proof of benefit is still lacking even after lots of studies. What isn’t lacking is the profit. :-))
Not to say that I don’t believe in supplementation, I take a few “natural” products to help with this and side effects of the meds. However, given how many times I have heard to eat this or that, take this or that…the mental image that pops up for me (I’m sure those that have noticed me in the last couple of days realize I have an offbeat sense of humor) is that of the painted carriage and wagon with the hula girl out front, promising the elixir that will cure anything from headaches to hangnails. I realize it is a gaudy image and it makes me smile, but I don’t think that I am that far off the mark with it. 🙂
I would say before anyone takes anything, they should discuss it with their doctor, weigh the cost of the item (for me I’m only willing to spend a certain amount to try something which may or may not work), and best of all talk to real people about it (I talk to everyone and some of the best things I have heard come from the janitor at work, the guy behind the counter at the convenience store, etc.)
:silly: Too funny, Robin.
Sorry but I have to speak up here for a product I find extremely effective for me. Diagnosed with OA 5 yrs ago I find myself constantly massaging my aching wrists when I run out of Synflex, and never thinking about them when I am taking it regularly- which is key to its effectiveness. I, too, have a very sensitive BS detector and reject 99.9% of claims made by so-called natural miracle cures. For whatever reason this particular compound does the trick for me without anything else.
I appreciate the logic of this article and I’m always skeptical about things however I’d tried various things for my old dog with hip displacia (15 and yes, from the vet) but syn flex really did seem to make a difference. He did start going down steps again that he’d stopped going down (he’d do a circular route through the garden to avoid them). The placebo effect is ruled out in dogs. Maybe it’s seasonal, maybe he’s just having a good few months but if it works and isn’t going to do any harm, I’m willing to keep using it.